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Companies are increasingly asking which of their value chain activities are best performed within their own company and which may be outsourced. In addition, they are also considering which pieces of their value chain may be better performed abroad. These interrelated decisions concerning outsourcing and offshoring have not only changed entire industries, they have also transformed the lives of people across the world. Hundreds of millions of jobs in emerging nations have been the direct result of outsourcing and offshoring decisions. At the same time, many people in the developed world have lost their jobs because a company has been able to find a cheaper alternative. Featuring contributions from scholars in eleven different countries, this book was the first to examine the theory and practice of outsourcing and offshoring simultaneously. It includes studies of a variety of different industries, including pharmaceuticals, automobiles, medical records, appliances, human resource management and telecommunications.

Much of Europe remains plagued by high levels of unemployment. Fighting Unemployment critically assesses the widely accepted view that the culprit is excessive labor market regulation and overly generous welfare state benefits. The chapters include both cross-country statistical analyses and country case studies and are authored by economists from seven North American and European countries. They challenge the standard free market prescription that lower wages for less skilled workers, weaker labor unions, greater decentralization in bargaining, less generous unemployment benefits, and much less job security are necessary for good employment performance. There is little or no evidence of an equality-employment tradeoff: more wage equality is not associated with higher unemployment (or lower employment) rates. And while some recent statistical tests of the role of protective labor market institutions across the most affluent countries have been interpreted to lend support to the orthodox view and have been highly influential in both professional and policy circles, these results are shown to vary significantly across studies and to be highly sensitive to minor changes in the way the tests are run. The case study chapters suggest that good employment performance has been achieved less by shrinking the welfare state and deregulating the labor market than by effectively coordinating macroeconomic and social policies with the wage bargaining system —an achievement that requires both strong employer and union associations and a relatively stable and consensual political environment. The larger message of this book is that fundamentally different labor market models are compatible with low unemployment, ranging from the free market “American Model” to the much more regulated and coordinated Scandinavian systems.

This book was the first to examine the theory and practice of outsourcing and offshoring simultaneously.

With much of Europe plagued by high levels of unemployment, it has become widely accepted that the culprit is labor market rigidity and that the prescription can only be labor market deregulation: lower wages, higher earnings inequality, greater decentralization in bargaining, less generous unemployment benefits, more hiring flexibility, and less job security. Fighting Unemployment critically assesses this free market orthodoxy. With cross-country statistical analyses and country case studies, leading economists from seven North American and European countries contend that this conventional wisdom has greatly exaggerated the extent to which the unemployment problem can be blamed on protective labor market institutions and that the case for dismantling the welfare state to fight unemployment rests more on free market ideology than on the empirical evidence. The larger message of this book is that fundamentally different labor market models - ranging from the 'American Model' to the much more regulated and coordinated Scandinavian systems - are compatible with low unemployment.

Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.

The relationship between employment instability and fertility is a major topic in demographic research, with a proliferation of published papers on this matter, especially since the Great Recession. Employment instability, which most often man i fests in unem ploy ment or time-lim ited employ ment, is usu ally deemed to have a neg a tive effect on fertility, although different fertility reactions are hypothesized by sociological the o ries, and micro-level evi dence is fragmented and con tra dic tory. We used meta-analytic techniques to synthesize European research findings, offer general conclusions about the effects of employ ment insta bil ity on fer til ity (in terms of direc tion and size), and rank dif fer ent sources of employ ment insta bil ity. Our results sug gest that employment insta bil ity has a nonnegligible neg a tive effect on fer til ity. Men’s unem ploy ment is more det ri men tal for fer til ity than men’s time-lim ited employ ment; con versely, a woman having a fixed-term contract is least likely to have a child. Next, the negative effect of employ ment instability on fer til ity has become stronger over time, and is more severe in Southern Euro pean countries, where social pro tec tion for fam i lies and the unem ployed is least gen er ous. Finally, meta-regres sion esti ma tes dem on strate that fail ing to account for income and part ner char ac ter is tics leads to an over es ti ma tion of the neg a tive effect of employ ment insta bil ity on fer til ity. We advance the role of these two fac tors as poten tial mech a nisms by which employ ment insta bil ity affects fer til ity. Overall, this meta-analysis provides the empirical foundation for new studies on the topic.

The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care (PEH). We estimated the effects of changes in unemployment and PEH on cancer mortality, and identified how universal health coverage (UHC) affected these relationships. For this longitudinal analysis, we obtained data from the World Bank and WHO (1990–2010). We aggregated mortality data for breast cancer in women, prostate cancer in men, and colorectal cancers in men and women, which are associated with survival rates that exceed 50%, into a treatable cancer class. We likewise aggregated data for lung and pancreatic cancers, which have 5 year survival rates of less than 10%, into an untreatable cancer class. We used multivariable regression analysis, controlling for country-specific demographics and infrastructure, with time-lag analyses and robustness checks to investigate the relationship between unemployment, PEH, and cancer mortality, with and without UHC. We used trend analysis to project mortality rates, on the basis of trends before the sharp unemployment rise that occurred in many countries from 2008 to 2010, and compared them with observed rates. Data were available for 75 countries, representing 2·106 billion people, for the unemployment analysis and for 79 countries, representing 2·156 billion people, for the PEH analysis. Unemployment rises were significantly associated with an increase in all-cancer mortality and all specific cancers except lung cancer in women. By contrast, untreatable cancer mortality was not significantly linked with changes in unemployment. Lag analyses showed significant associations remained 5 years after unemployment increases for the treatable cancer class. Rerunning analyses, while accounting for UHC status, removed the significant associations. All-cancer, treatable cancer, and specific cancer mortalities significantly decreased as PEH increased. Time-series analysis provided an estimate of more than 40 000 excess deaths due to a subset of treatable cancers from 2008 to 2010, on the basis of 2000–07 trends. Most of these deaths were in non-UHC countries. Unemployment increases are associated with rises in cancer mortality; UHC seems to protect against this effect. PEH increases are associated with reduced cancer mortality. Access to health care could underlie these associations. We estimate that the 2008–10 economic crisis was associated with about 260 000 excess cancer-related deaths in the Organisation for Economic Co-operation and Development alone. None.

This article reviews research on the effects of economic recessions on fertility in the developed world. We study how economic downturns, as measured by various indicators, especially by declining GDP levels, falling consumer confidence, and rising unemployment, were found to affect fertility. We also discuss particular mechanisms through which the recession may have influenced fertility behavior, including the effects of economic uncertainty, falling income, changes in the housing market, and rising enrollment in higher education, and also factors that influence fertility indirectly such as declining marriage rates. Most studies find that fertility tends to be pro-cyclical and often rises and declines with the ups and downs of the business cycle. Usually, these aggregate effects are relatively small (typically, a few percentage points) and of short durations; in addition they often influence especially the timing of childbearing and in most cases do not leave an imprint on cohort fertility levels. Therefore, major long-term fertility shifts often continue seemingly uninterrupted during the recession—including the fertility declines before and during the Great Depression of the 1930s and before and during the oil shock crises of the 1970s. Changes in the opportunity costs of childbearing and fertility behavior during economic downturn vary by sex, age, social status, and number of children; childless young adults are usually most affected. Furthermore, various policies and institutions may modify or even reverse the relationship between recessions and fertility. The first evidence pertaining to the recent recession falls in line with these findings. In most countries, the recession has brought a decline in the number of births and fertility rates, often marking a sharp halt to the previous decade of rising fertility rates.

Since the early 1990s, recoveries from recessions in the US have been plagued by weak employment growth. We investigate whether a similar problem afflicts other developed economies, and whether technology is a culprit. We study recoveries from 71 recessions in 28 industries and 17 countries from 1970-2011. We find that though GDP recovered more slowly after recent recessions, employment did not. Industries that used more routine tasks, and those more exposed to robotization, did not recently experience slower employment recoveries. Finally, middle-skill employment did not recover more slowly after recent recessions, and this pattern was no different in routine-intensive industries.